Anemias in Oncology: Potential of Maintenance Therapy

AV Snegovoi, VB Larionova, LV Manzyuk, IB Kononenko

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Anton Vladimirovich Snegovoi, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-41-09; e-mail: anvs2012@gmail.com

For citation: Snegovoi AV, Larionova VB, Manzyuk LV, Kononenko IB. Anemias in Oncology: Potential of Maintenance Therapy. Clinical oncohematology. 2016;9(3):326-35 (In Russ).

DOI: 10.21320/2500-2139-2016-9-3-326-35


ABSTRACT

Development of anemia during chemotherapy or chemoradiotherapy of malignancies is a serious adverse event negatively affecting the quality of life and effectiveness of the treatment. In this regard, the leading consensus committees of NCCN, ESMO, ASCO, and RUSSCO have prepared and are regularly updating recommendations for diagnosing and treatment of anemia in cancer patients. The article presents recent data on the pathogenesis and methods of treatment of anemia in cancer patients, including administration of erythropoiesis stimulating agents: recombinant erythropoietins, intravenous iron products, vitamins, and red blood cell transfusions.


Keywords: cancer, anemia, erythropoietins, intravenous iron products, red blood cell transfusions.

Received: February 29, 2016

Accepted: March 31, 2016

Read in PDF(RUS)pdficon


REFERENCES

  1. Knight K, Wade S, Balducci L. Prevalence and outcome of anemia in cancer: a systematic review of the literature. Am J Med. 2004;116(7);11–26. doi: 10.1016/j.amjmed.2003.12.008.
  2. Schrijvers D, De Samblanx H, Roila F. Erythropoiesis-stimulating agents in the treatment of anaemia in cancer patients: ESMO Clinical Practice Guidelines for use. Ann Oncol. 2010;21(Suppl 5):v244–v247. doi: 10.1093/annonc/mdq202.
  3. Ludwig H, Van Belle S, Barrett-Lee P, et al. The European Cancer Anaemia Survey (ECAS): A large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer. 2004;40(15):2293–306. doi: 10.1016/j.ejca.2004.06.019.
  4. Groopman J, Itri L. Chemotherapy-induced anemia in adults: incidence and treatment. J Nat Cancer Inst. 1999;91(19):1616–34. doi: 10.1093/jnci/91.19.1616.
  5. Food and Drug Administration. Jevtana (cabazitaxel) Injection Label Information. [Internet] Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/201023lbl.pdf. (accessed 12.11.2015).
  6. Food and Drug Administration. Taxotere (docetaxel) Injection Label Information. [Internet] Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020449s059lbl.pdf (accessed 12.11.2015).
  7. Food and Drug Administration. Xtandi (enzalutamide) Capsules Label Information. [Internet] Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/203415lbl.pdf. (accessed 12.11.2015).
  8. Cella D. Quality of life and clinical decisions in chemotherapy-induced anemia. Oncology (Williston Park). 2006;20(8 Suppl 6):25–8.
  9. Caro JJ, Salas M, Ward A, et al. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001;91(12):2214–21. doi: 10.1002/1097-0142(20010615)91:12<2214::aid-cncr1251>3.0.co;2-p.
  10. Glaspy J. Update on Safety of ESAs in Cancer-Induced Anemia. J Natl Compr Cancer Network. 2012;10(5):659–66.
  11. Nowrousian M, Smyth JF, et al, eds. rhErythropoietin in cancer supportive treatment. New York: Marcel Dekker Inc; 1996. pp. 13–34.
  12. Павлов А.Д., Морщакова Е.Ф., Румянцев А.Г. Эритропоэз, эритропоэтин, железо. Молекулярные и клинические аспекты. М.: ГЭОТАР-Медиа, 2011. 304 с.
    [Pavlov AD, Morshchakova EF, Rumyantsev AG. Eritropoez, eritropoetin, zhelezo. Molekulyarnye i klinicheskie aspekty. (Erythropoiesis, erythropoietin, and iron. Molecular and clinical aspects.) Moscow: GEOTAR-Media Publ.; 2011. 304 p. (In Russ)]
  13. Grotto HZ. Anaemia of cancer: an overview of mechanisms involved in its pathogenesis. Med Oncol. 2008;25(1):12–21. doi: 10.1007/s12032-007-9000-8.
  14. Aapro M, Osterborg A, Gascon P, et al. Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron. Ann Oncol. 2012;23(8):1954–62. doi: 10.1093/annonc/mds112.
  15. Khorana AA, Francis CW, Blumberg N, et al. Blood transfusions, thrombosis and mortality in hospitalized cancer patients. Arch Int Med. 2008;168(21):2377–81. doi: 10.1001/archinte.168.21.2377.
  16. Amato A, Pescatori M. Perioperative blood transfusions for the recurrence of colorectal cancer. Cochrane database syst.rev. 2006;25(1):CD005033. doi: 10.1002/14651858.cd005033.pub2.
  17. Hoff CM, Lassen P, Eriksen JG, et al. Does transfusion improve the outcome for HNSCC patients treated with radiotherapy? Results from the randomized DAHANCA 5 and 7 trials. Acta Oncologica. 2011;50(7):1006–14. doi: 10.3109/0284186X.2011.592650.
  18. Egrie JC, Browne JK. Development and characterization of novel erythropoiesis stimulating protein (NESP). Br J Cancer. 2001;84(Suppl 1):3–10. doi: 10.1054/bjoc.2001.1746.
  19. Bohlius J, Wilson J, Seidenfeld J, et al. Recombinant human erythropoietins and cancer patients: updated meta-analysis of 57 studies including 9353 patients. J Natl Cancer Inst. 2006;98(10):708–14. doi: 10.1093/jnci/djj189.
  20. Tonelli M, Hemmelgarn B, Reiman T, et al. Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis. CMAJ. 2009;180(11):E62–E71. doi: 10.1503/cmaj.090470.
  21. Bennett C, Silver S, Djulbegovic B, et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA. 2008;299(8):914–24. doi: 10.1001/jama.299.8.914.
  22. Ludwig H, Crawford J, Osterborg A, et al. Pooled analysis of individual patient-level data from all randomized, double-blind, placebo-controlled trials of darbepoetin alfa in the treatment of patients with chemotherapy-induced anemia. J Clin Oncol. 2009;27(17):2838–47. doi: 10.1200/jco.2008.19.1130.
  23. Glaspy J, Crawford J, Vansteenkiste J, et al. Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes. Br J Cancer. 2010;102(2):301–15. doi: 10.1038/sj.bjc.6605498.
  24. Oncologic Drug Advisory Committee (ODAC) Meeting Information Package. Darbepoetin alfa (BLA #103951) and Epoetin alfa (BLA #103234). [Internet] Available from: http://www.scribd.com/doc/1117102/US-Food-and-Drug-Administration-20074301b20101Amgen. (accessed 20.02.2016).
  25. Glaspy J, Osterborg A, Ludwig H, et al. Evaluation of the association between (Hb) events and safety outcomes in cancer patients with chemotherapy induced anemia: an integrated analysis of patient-level data from 6 randomized, placebo-controlled trials of darbepoetin. Eur J Cancer. 2007;5(4):147–8. doi: 10.1016/s1359-6349(07)70639-0.
  26. Снеговой А.В., Aapro M., Давиденко И.С. и др. Практические рекомендации по лечению анемии у онкологических больных. Злокачественные опухоли. 2015;4:316–26. doi: 10.18027/2224-5057-2015-4s-316-326. [Snegovoi AV, Aapro M, Davidenko IS, et al. Practical recommendations for management of anemia in cancer patients. Zlokachestvennye opukholi. 2015;4:316–26. doi: 10.18027/2224-5057-2015-4s-316-326. (In Russ)]
  27. Henke M, Laszig R, Rube C, et al. Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial. The Lancet. 2003;362(9392):1255–60. doi: 10.1016/s0140-6736(03)14567-9.
  28. Leyland-Jones B, Semiglazov V, Pawlicki M, et al. Maintaining normal hemoglobin levels with epoetin alfa in mainly nonanemic patients with metastatic breast cancer receiving first-line chemotherapy: a survival study. J Clin Oncol. 2005;23(25):5960–72. doi: 10.1200/jco.2005.06.150.
  29. Delarue R, Haioun C, Coiffier B, et al. Survival effect of darbepoetin alfa in patients with diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy: The LNH03-6B study. J Clin Oncol. 2011;29: Abstract 9048.
  30. Nitz U, Gluz O, Oberhoff C, et al. Adjuvant chemotherapy with or without darbepoetin alpha in node-positive breast cancer: survival and quality of life analysis from the prospective randomized WSG ARA plus trial. Cancer Res. 2012;71(24 Suppl):PD07-06. doi: 10.1158/0008-5472.sabcs11-pd07-06.
  31. National Institute for Health and Care Excellence. Health Technology Appraisal Programme. Equality impact assessment – Guidance development. MTA Erythropoiesis-stimulating agents (epoetin and darbepoetin) for treating anaemia in people having cancer treatment (including review of TA142). [Internet] Available from: https://www.nice.org.uk/guidance/ta323/documents/anaemia-cancertreatment-induced-erythropoiesisstimulating-agents-epoetin-and-darbepoetin-inc-rev-ta142-equality-impact-assessment-guidance-development2. (accessed 06.06.2016).
  32. Aapro M, Osterborg A, Gascon P, et al. Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron. Ann Oncol. 2012;23(8):1954–62. doi: 10.1093/annonc/mds112.
  33. Beale AL, Penney MD, Allison MC. The prevalence of iron deficiency among patients presenting with colorectal cancer. Colorectal Dis. 2005;7(4):398–402. doi: 10.1111/j.1463-1318.2005.00789.x.
  34. Kuvibidila S, Gauthier T, Rayford W. Increased levels of serum transferrin receptor and serum transferrin receptor/log ferritin ratios in men with prostate cancer and the implications for body-iron stores. J Lab Clin Med. 2004;144(4):176–82. doi: 10.1016/j.lab.2004.03.017.
  35. Steinmetz HT, Tsamaloukas A, Schmitz S, et al. A new concept for the differential diagnosis and therapy of anaemia in cancer patients. Supp Care Cancer. 2010;19(2):261–9. doi: 10.1007/s00520-010-0812-2.
  36. Beguin Y, Lybaert W, Bosly A. A prospective observational study exploring the impact of iron status on response to darbepoetin alfa in patients with chemotherapy induced anemia. Blood. 2009;114(22): Abstract 2007.
  37. Ludwig H, Muldur E, Endler G, et al. High prevalence of iron deficiency across different tumors correlates with anemia, increases during cancer treatment and is associated with poor performance status. Haematologica. 2011;96: Abstract 982.
  38. Dangsuwan P, Manchana T. Blood transfusion reduction with intravenous iron in gynecologic cancer patients receiving chemotherapy. Gynecol Oncol. 2010;116(3):522–5. doi: 10.1016/j.ygyno.2009.12.004.
  39. Kim YT, Kim SW, Yoon BS, et al. Effect of intravenously administered iron sucrose on the prevention of anemia in the cervical cancer patients treated with concurrent chemoradiotherapy. Gynecol Oncol. 2007;105(1):199–204. doi: 10.1016/j.ygyno.2006.11.014.
  40. Steinmetz HT. The role of intravenous iron in the treatment of anemia in cancer patients. Ther Adv Hematol. 2012;3(3):177–91. doi: 10.1177/ 2040620712440071.
  41. Henry DH. Parenteral Iron Therapy in Cancer-Associated Anemia. Hematology. 2010;2010(1):351–6. doi: 10.1182/asheducation-2010.1.351.
  42. Auerbach M, Silberstein PT, Webb RT, et al. Darbepoetin alfa 300 or 500 mg once every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. Am J Hematol. 2010;85(9):655–63. doi: 10.1002/ajh.21779.
  43. Bastit L, Vandebroek A, Altintas S, et al. Randomized, multicenter, controlled trial comparing the efficacy and safety of darbepoetin alpha administered every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. J Clin Oncol. 2008;26(10):1611–8. doi: 10.1200/jco.2006.10.4620.
  44. Henry DH, Dahl NV, Auerbach M, et al. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. The Oncologist. 2007;12(2):231–42. doi: 10.1634/theoncologist.12-2-231.
  45. Pedrazzoli P, Farris A, Del Prete S, et al. Randomized trial of intravenous iron supplementation in patients with chemotherapy-related anemia without iron deficiency treated with darbepoetin alpha. J Clin Oncol. 2008;26(10):1619–25. doi: 10.1200/jco.2007.12.2051.
  46. Steensma DP, Sloan JA, Dakhil SR, et al. Phase III, randomized study of the effects of parenteral iron, oral iron, or no iron supplementation on the erythropoietic response to darbepoetin alfa for patients with chemotherapy-associated anemia. J Clin Oncol. 2011;29(1):97–105. doi: 10.1200/jco.2010.30.3644.
  47. Beguin Y, Maertens J, De Prijck B, et al. Darbepoetin-alfa and I.V. iron administration after autologous hematopoietic stem cell transplantation: a prospective randomized multicenter trial. Am J Hematol. 2013;88(12):990–6. doi: 10.1002/ajh.23552.
  48. Hedenus M, Birgegard G, Nasman P, et al. Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study. Leukemia. 2007;21:627–32. doi: 10.1038/sj.leu.2404562.
  49. Gafter-Gvili A, Rozen-Zvi B, Vidal L, et al. Intravenous iron supplementation for the treatment of cancer-related anemia—systematic review and meta-analysis. Acta Oncologica. 2013;52(1):18–29. doi: 10.3109/0284186x.2012.702921.
  50. Petrelli F, Borgonovo K, Cabiddu M, et al. Addition of iron to erythropoiesis-stimulating agents in cancer patients: a meta-analysis of randomized trials. J Cancer Res Clin Oncol. 2012;138(2):179–87. doi: 10.1007/s00432-011-1072-3.
  51. Сельчук В.Ю., Чистяков С.С., Толокнов Б.О. и др. Железодефицитная анемия: современное состояние проблемы. Русский медицинский журнал. 2012;3(1):1–8.
    [Sel’chuk VYu, Chistyakov SS, Toloknov BO, et al. Iron-deficiency anemia: state-of-the-art of the problem. Russkii meditsinskii zhurnal. 2012;3(1):1–8. (In Russ)]